The persistence of health disparities in medically underserved minority communities remains one of the most vexing public health problems facing our nation;the etiology of racial/ethnic differences in health involves dynamic interactions between genetic, behavioral and social-environmental determinants. Yet the field lacks robust, longitudinal datasets that integrate these multi-dimensional data elements with clinical assessments in minority patient cohorts. The Minority Health Genomics and Translational Research BIo-Repository Database (MH-GRID) Network infrastructure will facilitate the ascertainment of biospecimens, the collection of multi- dimensional data elements and the tracking of patient outcomes in an electronic health records (EHRs)-linked data warehouse within a consortium of minority clinics. This initiative will expand the diversity of bio-ancestral groups in national genomic medicine cohorts, provide a platform for 'virtual'disease registries catalyze comparative effectiveness research in high-health disparity settings and accelerate the translation of 'personalized medicine'into minority communities. This project will fulfill the objectives of the NIH Director's priority areas (RFA-OD-10-005) and the ARRA by pursuing the following specific aims: Aim I: To establish an organizational framework for the Minority Health-GRID Network as a consortium of academic medical centers and minority-serving 'safety-net'medical care facilities. Aim II: To establish an electronic health record (EHR)-linked bioinformatics/bio-repository infrastructure that facilitates in-depth genotyping, phenotypic characterization and longitudinal surveillance of minority patients. Aim III: To demonstrate the unique utility of the MH-GRID resource with a 'use-case'project that defines the genetic, personal and social-environmental determinants of severe hypertension (HTN) in African-Americans. The fulfillment of these specific aims will enable the MH-GRID to establish the largest genomic medicine database devoted to minority patients. A major objective of the MH-GRID is to utilize high-throughput sequencing technology to create a genome-wide catalogue of the 'Exome'in 2400 African-Americans (AA). Overall, this project provides a 'grand opportunity'to establish a novel national research resource that will advance genomic science while addressing a variety of health disparity conditions that currently plague under- served minority communities. PUBLIC HEALTH RELEVANCE: High blood pressure is a very common problem that is a major cause of heart attacks, strokes and kidney failure. It affects African-Americans much more commonly than other racial groups. There are many diseases like high blood pressure that are more common in certain racial/ethnic and there is a need to improve the use of computerized systems in clinics that care for a high proportion of minority patients so that their health status can be improved. In addition, there is much that we have to learn about genetic differences between different minority groups that may contribute to these differences in health. The proposed project will be a major innovation to fill this knowledge gap in the areas of genetics and health disparities.